Provider Demographics
NPI:1952808651
Name:THOMPSON, PHYLLIS (DNP FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-2001
Mailing Address - Country:US
Mailing Address - Phone:870-733-6388
Mailing Address - Fax:901-405-5889
Practice Address - Street 1:900 N 7TH ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-2001
Practice Address - Country:US
Practice Address - Phone:870-735-3842
Practice Address - Fax:870-394-4872
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005681363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner